参附注射液联合硝酸甘油治疗慢性心力衰竭急性发作的临床观察

Clinical observation of Shenfu injection combined with nitroglycerin in the treatment of acute attack of chronic heart failure

目的观察参附注射液联合硝酸甘油注射液治疗慢性心力衰竭的临床效果。方法 80例慢性心力衰竭患者随机分为治疗组和对照组,每组40例。两组均给予常规治疗,治疗组在常规治疗基础上静注参附注射液和硝酸甘油注射液,对照组在常规治疗基础上静注米力农。比较两组治疗前后的脑钠素(BNP)水平、6 min步行距离及左室舒张末期内经(LVEDD)、左室收缩末期内径(LVESD)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)及左室射血分数(LVEF),并对比两组的疗效。结果治疗后,两组的BNP水平均较治疗前降低,且以治疗组更为显著(P<0.05);两组6 min步行距离均较治疗前加大,且以治疗组更为显著(P<0.05);两组的LVEF值较治疗前高,且以治疗组更为显著(P<0.05);对照组的LVESD、LVEDV值低于治疗前及同期的治疗组(P<0.05),治疗组的临床疗效优于对照组(P<0.05)。结论参附注射液联合硝酸甘油注射液较单用米力农治疗可以明显改善慢性心力衰竭患者的心功能情况,值得临床推广。

Objective To observe the clinical effect of Shenfu injection combined with nitroglycerin in the treatment of acute attack of chronic heart failure. Methods A total of 80 patients were randomly divided into the Treatment Group and Control Group, 20 cases in each group. Both groups were given conventional therapy, based on which the Treatment Group was intravenously injected with Shenfu injection combined with nitroglycerin injection and the Control Group was intravenously injected with milrinone. The BNP level, 6-minute walking distance, LVEDD, LVESD, LVESV, LVEDV and LVEF before and after the treatment were observed in the two groups, and the clinical efficacy was compared between the two groups. Result After the treatment, both groups had the BNP level lower than that before the treatment, and the Treatment Group showed a more significant change (P<0.05);Both groups had the 6-minute walking distance longer than that before the treatment, and the Treatment Group showed a more significant change (P<0.05);Both groups had the LVEF value higher than that before the treatment, and the Treatment Group showed a more significant change (P<0.05);the Control Group had the LVESD and LVEDV value lower than those before the treatment and those of the Treatment Group at the same period (P<0.05), and the clinical efficacy of the Treatment Group was superior to that of the Control Group (P<0.05). Conclusion Shenfu injection combined with nitroglycerin injection can significantly improve the cardiac function of patients with chronic heart failure compared with the administration with milrinone alone.